title: Prognostic impact of body mass index in patients with squamous cell carcinoma of the esophagus.
abstract: OBJECTIVE
  To clarify the prognostic impact of body mass index (BMI) in patients with esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  Two hundred forty-three patients who underwent esophagectomy for ESCC from April 2005 through December 2010 were eligible. Prognoses of the patients were compared between groups stratified according to BMI. We also analyzed the survival difference using propensity score matching to adjust differences in staging and treatment.
  
  
  RESULTS
  Low, normal, and high BMI groups had 35, 177, and 31 patients, respectively. The low BMI group included more advanced cases than did the normal BMI group, while tumor stage was equivalent in the normal and high BMI groups. Disease-free survival of the low and high BMI groups was significantly worse than that of the normal BMI group (P<0.0001 between the low and normal BMI groups; P = 0.0076 between the normal and high BMI groups). Disease-free survival of the high BMI group was significantly worse than that of the normal BMI group in the propensity score-matched cohort (P = 0.0020). Multivariate analysis in this cohort demonstrated that high BMI was an independent prognostic factor (hazard ratio 2.949, 95% confidence interval, 1.132-7.683).
  
  
  CONCLUSIONS
  High BMI was an independent prognostic factor after curative esophagectomy for ESCC. Although further analysis is required to clarify the influence of overweight on the biological features of ESCC, glucose metabolism may be a therapeutic target for ESCC.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Ishimoto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Baba
authors.forename: Yohei
authors.initials: Y
authors.lastname: Nagai
authors.forename: Naoya
authors.initials: N
authors.lastname: Yoshida
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate